This application is a request for a Cancer Prevention, Control, Behavioral and Population Sciences Career Development Award from NCI to enable Dr. Christopher Sciamanna to develop research expertise in studying the use of brief computer-tailored printed prompts to encourage and guide physicians to counsel their patients about lowering their cancer risk from smoking, physical inactivity and a poor diet. Dr. Sciamanna will work closely with his mentor, Dr. David Abrams, and his co- mentors, Drs. Goldstein, Marcus, Borrelli and Guns from the Brown University School of Medicine. Dr. Sciamanna's goals are to develop behavioral counseling skills along with skills in nutrition research methodology and to apply those skills in developing a programmatic line of research in understanding the potential for using computers to assist physicians in cancer risk behavior counseling. Smoking, poor diet and a sedentary lifestyle are among the chief preventable causes of cancer morbidity and mortality in the United States. Physician counseling can help patients to modify cancer risk behaviors, yet is underutilized. Using computers to tailor patient-specific, printed reports have shown efficacy in helping individuals to modify risk behaviors, yet the efficacy of using such reports to prompt and guide physician behavior modification counseling remains unclear. Aim 1) To develop the "second generation" of a computer program that prints brief, patient-specific reports for physicians regarding smoking, physical inactivity and a poor diet. Aim 2) Given the lack of a measure of nutrition counseling, we will develop and test the validity of a patient exit interview to measure the extent of physical dietary counseling to lower cancer risk, in primary care settings. Aim 3) To determine, via a 12 month randomized controlled trial design, the efficacy of providing computer-tailored smoking cessation, physical activity, and nutrition counseling prompts to physicians on physician counseling behavior. Results of the proposed study will increase our understanding of how best to use computers to assist physicians in counseling their patients about cancer risk behaviors and will form the basis for an effect size calculation for a future application to study the effect of the printed counseling prompts on patient-level outcomes.